Approximately 15-20 million people in Europe and the United States go to the emergency department every year with chest pain. Many can be discharged early if they are not having an acute coronary syndrome. A large new single-center observational study, presented at the American College of Cardiology meeting in Washington, DC and published simultaneously in the Journal of the American College of Cardiology, provides fresh evidence that high-sensitivity cardiac troponin T (hs-cTnT) may be useful in helping identify chest pain patients in the emergency department who do not need to be admitted to the hospital.
Nadia Bandstein reported on 14,636 patients who presented to the emergency department at a Swedish hospital and had a hs-cTnT test. 61% (8,907) of the people had a hs-cTnT below 5 ng/l. At 30 days only 0.44% (39) of these patients had an MI. None of the patients in this group died. 15 had MIs with no ischemic ECG changes. The authors calculated a negative predictive value of 99.8%.
SOURCE: Larry Husten